Alzheimer's Disease and Memory

Immunotherapy Linked to Lower Risk of Alzheimer's Disease

ababb@aan.com — Mon, 20 Jul 2009 21:00:00 GMT

IVIg treatments, the addition of good antibodies into the blood stream, may hold promise for lowering the risk of Alzheimer's disease and other similar brain disorders, according to research published in the July 21, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. "In our study, we looked at the association of the use of intravenous immunoglobulin (IVIg) with the occurrence of Alzheimer's disease. IVIg has been used safely for more than 20 years to treat other diseases but is thought to have an indirect effect on Alzheimer's disease by targeting beta-amyloid, or plaques in the brain," said Howard Fillit, MD, with the Mount Sinai School of Medicine in New York. For the study, researchers analyzed the medical records of 847 people given at least one treatment of IVIg over four years and 84,700 who were not given IVIg treatment. Participants were treated for immune deficiencies, leukemia or other types of cancer, anemia and other diseases. The records were pulled from a database of 20 million patients age 65 or older developed by SDI Health. Scientists made sure the groups were similar in their risk factors for Alzheimer's disease. The study found that people who received IVIg for other conditions had a 42-percent lower risk of developing Alzheimer's disease over four years compared to those who did not receive IVIg. Only 2.8 percent of those treated with IVIg developed Alzheimer's disease compared with 4.8 percent of those not treated with immune-based therapy. "Our study provides evidence that previous IVIg treatments may protect against Alzheimer's disease," said Fillit. "The current Alzheimer's drugs on the market treat the symptoms of the disease. Immunization could treat the underlying cause." "These findings do not constitute an endorsement of IVIg treatment for Alzheimer's disease. A large scale clinical trial is underway to determine whether IVIg could be an effective treatment for Alzheimer's," researchers said. The study was supported by Baxter International Inc., a manufacturer of IVIg. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as multiple sclerosis, restless legs syndrome, Alzheimer's disease, narcolepsy, and stroke. For more information about the American Academy of Neurology, visit www.aan.com or www.thebrainmatters.org.

Cognitive Testing, Gender and Brain Lesions May Predict MS Disease Progression Risk

ababb@aan.com — Wed, 29 Jul 2009 21:00:00 GMT

Cognitive testing may help people with inactive or benign multiple sclerosis (MS) better predict their future with the disease, according to a study published in the July 29, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology. Gender and brain lesions may also determine the risk of progression of MS years after diagnosis. By current definition, people with benign MS are those who remain "fully functional" after 15 or more years from disease onset. However, people with benign MS occasionally develop renewed disease activity or progression, and can experience severe symptoms. For the study, researchers looked at the cognitive test results and brain scans of 63 people with benign MS during a period of five years. Of those, 43 were women and 20 were men. The cognitive tests included verbal and visual memory, attention, concentration and the speed at which the participant processed information. Brain scans revealed the number of lesions associated with MS on the person's brain. Follow-up neurologic exams were done every six months. The study found that nearly 30 percent of people with benign MS significantly worsened over the course of five years. People who failed more than two cognitive tests (out of 10 total) were 20 percent more likely to progress over time. Men with benign MS were nearly three times more likely to later experience signs of MS compared to women. People with more brain lesions detected on scans were also more likely to develop signs of the disease. "Our findings strongly suggest that a person's gender, cognitive state and amount of lesions on the brain are important factors for predicting MS progression," said study author Maria Pia Amato, MD, with the University of Florence in Italy. "Our study highlights the importance of cognitively testing people with benign MS who appear to be healthy. This information might be important in tailoring the patient's treatment." The study was supported by the Italian Multiple Sclerosis Association. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

'Brain Exercises' May Delay Memory Decline in Dementia

ababb@aan.com — Mon, 03 Aug 2009 21:00:00 GMT

People who engage in activities that exercise the brain, such as reading, writing, and playing card games, may delay the rapid memory decline that occurs if they later develop dementia, according to a study published in the August 4, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. The study involved 488 people age 75 to 85 who did not have dementia at the start of the study. They were followed for an average of five years; during that time 101 of the people developed dementia. At the beginning of the study, people reported how often they participated in six leisure activities that engage the brain: reading, writing, doing crossword puzzles, playing board or card games, having group discussions, and playing music. For each activity, daily participation was rated at seven points, several days a week was rated at four points, and weekly participation was rated at one point. The average was seven points total for those who later developed dementia, meaning they took part in one of the six activities each day, on average. Ten people reported no activities, and 11 reported only one activity per week. The researchers then looked at the point when memory loss started accelerating rapidly for the participants. They found that for every additional activity a person participated in, the onset of rapid memory loss was delayed by 0.18 years. "The point of accelerated decline was delayed by 1.29 years for the person who participated in 11 activities per week compared to the person who participated in only four activities per week," said study author Charles B. Hall, PhD, of Albert Einstein College of Medicine in Bronx, NY. The results remained valid after researchers factored in the education level of the participants. "The effect of these activities in late life appears to be independent of education," Hall said. "These activities might help maintain brain vitality. Further studies are needed to determine if increasing participation in these activities could prevent or delay dementia." The study was supported by the National Institute on Aging. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

Brain Damage Seen on Brain Scans May Predict Memory Loss in Old Age

ababb@aan.com — Mon, 10 Aug 2009 21:00:00 GMT

Areas of brain damage seen on brain scans and originally thought to be related to stroke may help doctors predict a person's risk of memory problems in old age, according to research published in the August 11, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers tested 679 people age 65 and older without dementia for mild cognitive impairment, the stage between normal aging and dementia. Participants underwent brain scans where scientists looked for small areas of brain damage called white matter hyperintensities, often referred to as ministrokes. They also looked for infarcts, or areas of dead tissue usually called strokes. Both types of brain damage may be caused by vascular disease in the brain. The study found that people with white matter hyperintensities were nearly twice as likely to have mild cognitive impairment that included memory loss. However, people who had infarcts on their brain scans were more likely to experience mild cognitive impairment in abilities other than memory loss. The results remained the same regardless of a person's age, gender, ethnic group, education, and if they had a gene thought to be a strong risk factor for dementia, called the ApoEe4 gene. "The most interesting finding in this study was that white matter hyperintensities, or ministrokes, predicted memory problems, while strokes predicted non-memory problems," said study author José Luchsinger, MD, MPH, with Columbia University Medical Center in New York. "Traditionally, ministrokes and strokes are thought to have a common origin and to more strongly predict non-memory cognitive problems. There are an increasing number of studies challenging the idea that all white matter hyperintensities are similar to strokes. The fact that white matter hyperintensities more strongly predicted memory problems could challenge traditional views that white matter hyperintensities are milder versions of stroke that are produced only by conditions such as high blood pressure," said Luchsinger. Luchsinger says more work is needed to understand white matter hyperintensities and to identify which are related to stroke and which are related to other conditions such as Alzheimer's disease. He says this could eventually help doctors and researchers to design preventive strategies for memory and other types of cognitive impairment. The study was supported by the National Institutes of Health. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com or www.thebrainmatters.org.

Children with Newly Diagnosed Epilepsy at Risk for Cognitive Problems

ababb@aan.com — Wed, 12 Aug 2009 21:00:00 GMT

Children who have normal IQs before they experience a first seizure may also have problems with language, memory, learning and other cognitive skills, according to a study published in the August 12, 2009, online issue of Neurology®, the medical journal of the American Academy of Neurology. "Our study highlights the importance of testing children with epilepsy for possible cognitive problems soon after they are diagnosed with epilepsy in order to avoid these issues affecting them later in life, especially if they have additional risk factors," said study author Philip Fastenau, PhD, Professor of Neurology at Case Western Reserve University School of Medicine and the Neurological Institute of University Hospitals in Cleveland, OH. The research was done in collaboration with Indiana University Purdue University in Indianapolis and Cincinnati Children's Hospital Medical Center. The study involved 282 school-aged children with an IQ of at least 70 who experienced their first seizure within the previous three months. They were then compared to 147 of their siblings without seizures. Scientists looked at whether the children with seizures also had other risk factors associated with cognitive problems, including multiple seizures, use of epilepsy drugs, or signs of epilepsy on early tests of brain waves. Of the children who experienced one seizure, 27 percent showed cognitive difficulties at or near the time of the first seizure and 40 percent of children who had additional risk factors showed signs of cognitive problems. A child with all four risk factors was three times more likely to experience cognitive problems by the first clinic visit compared to children who were seizure-free. The study also showed that children who took epilepsy drugs had difficulties in processing speed, language, verbal memory and learning compared to children who did not take any epilepsy drugs. "Children who take these medications should be closely monitored for cognitive problems resulting from the epilepsy drug," said Fastenau. "Surprisingly, our study also found academic achievement in these children was unaffected around the time of the first visit about three months after the first seizure in this study, suggesting there is a window early in epilepsy for intervention to avoid hurting a child's performance at school." "Because this study found cognitive problems at the time of the first seizure or soon after, it provides strong evidence that these cognitive problems can be attributed to underlying brain abnormalities that lead to the epilepsy, rather than from extended exposure to epilepsy drugs or the effect of numerous seizures," said David Loring, PhD, of Emory University in Atlanta, who wrote an editorial accompanying the study. -The study was supported by the National Institutes of Health. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, and multiple sclerosis. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

High Blood Pressure Linked to Memory Problems in Middle Age

ababb@aan.com — Mon, 24 Aug 2009 21:00:00 GMT

EMBARGOED FOR RELEASE UNTIL 4 P.M. ET, MONDAY, AUGUST 24, 2009 Media Contacts: Rachel Seroka, rseroka@aan.com, (651) 695-2738 Angela Babb, ababb@aan.com, (651) 695-2789 High Blood Pressure Linked to Memory Problems in Middle Age ST. PAUL, Minn. - High blood pressure is linked to memory problems in people over 45, according to research published in the August 25, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. The study found that people with high diastolic blood pressure, which is the bottom number of a blood pressure reading, were more likely to have cognitive impairment, or problems with their memory and thinking skills, than people with normal diastolic readings. For every 10 point increase in the reading, the odds of a person having cognitive problems was seven percent higher. The results were valid after adjusting for other factors that could affect cognitive abilities, such as age, smoking status, exercise level, education, diabetes or high cholesterol. The study involved nearly 20,000 people age 45 and older across the country who participated in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study and had never had a stroke or mini-stroke. A total of 1,505 of the participants, or 7.6 percent, had cognitive problems, and 9,844, or 49.6 percent, were taking medication for high blood pressure. High blood pressure is defined as a reading equal to or higher than 140/90 or taking medication for high blood pressure. "It's possible that by preventing or treating high blood pressure, we could potentially prevent cognitive impairment, which can be a precursor to dementia," said study author Georgios Tsivgoulis, MD, of the University of Alabama at Birmingham and a member of the American Academy of Neurology. Research has shown that high diastolic blood pressure leads to weakening of small arteries in the brain, which can result in the development of small areas of brain damage. Tsivgoulis said more research is needed to confirm the relationship between high blood pressure and cognitive impairment. The study was supported by the National Institute of Neurological Disorders and Stroke (NINDS). "The REGARDS study is one of the largest population-based studies of risk factors for stroke. These latest data suggest that higher blood pressure may be a risk factor for cognitive decline, but further studies will be necessary to understand the cause-effect relationship," said Walter J. Koroshetz, MD, deputy director of NINDS and Fellow of the American Academy of Neurology. "The National Institutes of Health is now organizing a large clinical trial to evaluate whether aggressive blood pressure lowering can decrease a number of important health outcomes including cognitive decline." The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com or www.thebrainmatters.org.

Infections May Lead to Faster Memory Loss in Alzheimer's Disease

ababb@aan.com — Mon, 07 Sep 2009 21:00:00 GMT

Getting a cold, stomach bug or other infection may lead to increased memory loss in people with Alzheimer's disease, according to research published in the September 8, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. The study found that people who had respiratory, gastrointestinal or other infections or even bumps and bruises from a fall were more likely to have high blood levels of tumor necrosis factor-?, a protein involved in the inflammatory process, and were also more likely to experience memory loss or other types of cognitive decline than people who did not have infections and who had low levels of the protein. The blood levels and cognitive abilities of 222 people with Alzheimer's disease with an average age of 83 were measured at the beginning of the study and three more times over six months. Caregivers were interviewed to determine whether the participants had experienced any infections or accidental injury that could lead to inflammation. A total of 110 people experienced an infection or injury that led to inflammation during the study. Those people experienced memory loss that was at twice the rate of those who did not have infections or injuries. People who had high levels of the protein in their blood at the beginning of the study, which may indicate chronic inflammation, had memory loss at four times the rate of those with low levels of the protein at the start of the study. Those who had high levels of the protein at the start of the study who also experienced acute infections during the study had memory loss at 10 times the rate of those who started with low levels and had no infections over the six-month period. "One might guess that people with a more rapid rate of cognitive decline are more susceptible to infections or injury, but we found no evidence to suggest that people with more severe dementia were more likely to have infections or injuries at the beginning of the study," said study author Clive Holmes, MRCPsych, PhD, of the University of Southampton in the United Kingdom. "More research needs to be done to understand the role of tumor necrosis factor-alpha in the brain, but it's possible that finding a way to reduce those levels could be beneficial for people with Alzheimer's disease." The study was supported by the Alzheimer's Society in London, UK. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease, and dementia. For more information about the American Academy of Neurology, visit www.aan.com or www.thebrainmatters.org

Problems Managing Money May Surface Shortly Before Alzheimer's Disease Sets In

ababb@aan.com — Mon, 21 Sep 2009 21:00:00 GMT

New research finds poor money management skills may indicate that a person with mild memory problems will soon develop Alzheimer's disease. The study is published in the September 22, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology. The study involved 76 older people with no memory problems and 87 older people with mild memory problems but no symptoms of dementia, known as mild cognitive impairment (MCI). The participants were given a money management test at the beginning of the study and then again after one year. The test included tasks of counting coins, making grocery purchases, understanding and using a checkbook, understanding and using a bank statement, preparing bills for mailing, and detecting fraud situations. After one year, 25 of the 87 people with MCI had developed Alzheimer's type dementia. The study found that while those people with no memory problems and those with MCI who did not develop dementia scored higher initially and maintained the same scores a year later, the scores of those people with MCI who developed dementia were lower initially and dropped by nine percent on checkbook management abilities, and six percent on overall financial knowledge and skills during the same period. "Our findings show that declining money management skills are detectable in patients with MCI in the year prior to developing Alzheimer's disease," said study senior author Daniel Marson, JD, PhD, with the Department of Neurology and Alzheimer's Disease Research Center at the University of Alabama at Birmingham. "Doctors should proactively monitor people with MCI for declining financial skills and advise them and their caregivers about steps they can take to watch for signs of poor money management," said Marson. "Caregivers should consider overseeing a person's checking transactions, contacting the person's bank to find money issues such as bills being paid twice, or become cosigners on the checking account so that both signatures are required for checks written above a certain amount. Online banking and bill payment services are also good options." The study was supported by the National Institute on Aging. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Parkinson's disease, ALS (Lou Gehrig's disease), dementia, West Nile virus, and ataxia. For more information about the American Academy of Neurology, visit http://www.aan.com or www.thebrainmatters.org.

Does Diabetes Speed Up Memory Loss in Alzheimer's Disease?

ababb@aan.com — Mon, 26 Oct 2009 21:00:00 GMT

Research has shown that diabetes increases the risk of Alzheimer's disease and the risk of memory loss in people who don't have Alzheimer's disease. But it hasn't been clear whether people with Alzheimer's disease and diabetes have more rapid memory loss than those who have Alzheimer's disease but no diabetes. New research published in the October 27, 2009, print issue of Neurology®, the medical journal of the American Academy of Neurology, suggests that those with both diseases actually have a slower rate of memory loss than people who had only Alzheimer's disease. "This result was surprising," said study author Caroline Sanz, MD, of INSERM, the French National Institute for Health and Medical Research in Toulouse. "Our initial hypothesis was that diabetes would increase the rate of cognitive decline in people with Alzheimer's disease." For the study, researchers followed 608 people with mild to moderate Alzheimer's disease for four years and tested their memory and thinking skills twice a year. A total of 63 people, or 10.4 percent, had diabetes. At the beginning of the study, both those with and without diabetes had average scores of 20 points on the cognitive test. Over each six-month testing period, the overall group declined by an average of 1.24 points on the test. However, those without diabetes declined by 0.38 points more per six-month period than those with diabetes. Researchers say it is not clear yet why the rate of memory loss was slower for people with diabetes. "One possible explanation is that diabetes in the elderly differs from that in younger people and in addition, elderly people with diabetes may be more likely to receive cardiovascular medications such as drugs for high blood pressure than people who don't have diabetes," Sanz said. "These drugs have been reported to decrease the risk of developing Alzheimer's disease and also the rate of cognitive decline in people with Alzheimer's disease. Other possible explanations for these findings may relate to differences in brain lesions in those people with diabetes compared to those without diabetes." The study was supported by the French Ministry of Health and the Toulouse University Hospital. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Parkinson's disease, ALS (Lou Gehrig's disease), dementia, West Nile virus, and ataxia. For more information about the American Academy of Neurology, visit http://www.aan.com or http://www.thebrainmatters.org. VIDEO: www.youtube.com/AANChannel TEXT: www.aan.com/press TWEETS: www.twitter.com/AANPublic

Is Disorder That Causes Dementia Hereditary?

ababb@aan.com — Mon, 02 Nov 2009 22:00:00 GMT

New research shows that a rare brain disorder that causes early dementia is highly hereditary. The study is published in the November 3, 2009, issue of Neurology®, the medical journal of the American Academy of Neurology. The brain disorder, called frontotemporal dementia, is formerly known as Pick's disease and destroys parts of the brain, leading to dementia, including problems with language or changes in behavior and personality. The disease often affects people under the age of 65. "Knowing your family's health history may be one way for people to better predict their risk of developing dementia," said study author Jonathan Rohrer, MRCP Clinical Research Fellow at the Dementia Research Center at the University College London in the United Kingdom. For the study, blood was drawn from 225 people who were diagnosed with frontotemporal dementia. The people were asked about family history of dementia and given a score of one through four. A score of one represents a person who had at least three relatives with dementia and an autosomal dominant inheritance, meaning that an affected person has one mutant gene and one normal gene and has a 50-percent chance of passing the mutant gene and therefore the disorder on to their offspring. A score of four represents a person with no family history of dementia. The study found that nearly 42 percent of participants scored between a one and a 3.5, meaning they had some family history of dementia. However, only 10 percent had an autosomal dominant gene history. The people in the study also had their DNA tested for five gene mutations thought to cause frontotemporal dementia. Mutations were found in two of the five genes. "Many people were still found to have a strong family history of dementia even without having any of the five known gene mutations, suggesting that there are still unknown genes that cause frontotemporal dementia," said Rohrer. "Discovering new genes and gene mutations could provide another key to unlocking the doors to new treatments and prevention strategies for dementia." The study also found that behavioral problems associated with frontotemporal dementia were the most likely to be hereditary, while language problems were the least likely to be hereditary. The study is supported by the United Kingdom Department of Health's NIHR Biomedical Research Centers, the Medical Research Council UK and the Alzheimer's Research Trust in the United Kingdom. November is National Alzheimer's Awareness Month. The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington's disease and dementia. For more information about the American Academy of Neurology, visit AAN Website or TheBrainMatters.org Website. VIDEO: www.youtube.com/AANChannel TEXT: www.aan.com/press TWEETS: www.twitter.com/AANPublic